Marking another major milestone in the fight against lung cancer, the United States Preventative Services Task Force (USPSTF) issued its July 29, 2013, draft recommendations endorsing low-dose CT screening for those at highest risk of developing lung cancer.

Recommendations

The draft recommendation calls for annual screening for an estimated 9 million Americans who meet the following criteria:

Are between 55 and 79 years of age

Have smoked more than 30 pack years in their lifetime (for example, a pack a day for 30 years, or two packs a day for 15 years)

Are current smokers or quit less than 15 years ago

Are generally healthy

The recommendation also acknowledges quitting smoking as the single most effective tool in preventing lung cancer deaths, and urges the inclusion of smoking cessation counseling and medication in screening efforts.

Reductions in lung cancer deaths

Lung cancer is by far the leading cause of cancer deaths in the United States, killing an estimated 160,000 Americans every year. Without screening, the average five-year survival rate for lung cancer is approximately 15%. By contrast, the International Early Lung Cancer Action Program (I-ELCAP) research has found that annual screening by skilled practitioners can result in a cure rate for lung cancer that may be as high as 75% or higher.

Major improvement in access to care

If this recommendation is finalized, it will have an enormous impact on patient access to lung cancer screening. With a B rating from the USPSTF, it is likely that Medicare and many health insurers will provide low-dose CT lung cancer screenings to beneficiaries without a co-pay. This coverage would likely go into effect after final release of the USPSTF recommendations.

I-ELCAP response and research

I-ELCAP applauds the USPSTF recommendations and believes this to be a critical step in reducing lung cancer deaths on a wide scale. Lead Investigator Dr. Claudia Henschke says, “It is going to make a big difference in how many people die of lung cancer. Back in 1999 when the Early Lung Cancer Action Project (ELCAP) published our initial results, the ELCAP investigators were very confident that screening would provide a major benefit. Now, finally, it will be made available to those people who are at highest risk. I am thrilled.”

Since the 1999 landmark first publication of ELCAP results in The Lancet, its successor, I-ELCAP, has aggressively pursued research to uncover the benefits of annual lung cancer screening with low-dose CT scans and to establish the protocols and best practices that maximize their net benefit. With widespread consensus that lung cancer screening can lead to significant reductions in lung cancer deaths, I-ELCAP research continues to refine diagnostic criteria and protocols, explore potential benefits in concurrent screening for heart disease risk factors, quantify the effects of secondhand tobacco smoke, and realize the opportunities annual screening presents for improving rates of smoking cessation.

Next steps

If you believe you are at risk of lung cancer and could benefit from lung cancer screening, talk to your healthcare provider.